After you file an insurance claim, the insurance company then evaluates the claim and decides to either accept it or deny it. In many cases, insurance denials are due to incorrect details on insurance claims. When this happens, the filer can correct his or her claim and resubmit it.
Insurance claims can also be denied when the insurance company deems the claim to be invalid. This could be for a number of reasons, such as the claim being for something that is not covered by the policy or because it does not fit the criteria for its claim type, such as a personal injury claim without evidence linking the insured’s actions to the claimant’s injury. It could also reject a claim on the basis that the filer was somehow at fault for his or her injury, such as by driving drunk.
Not all insurance disputes are denials. Sometimes, they occur when claims are accepted and offered far smaller compensation packages than their filers feel they are entitled to receive. Just like denied claims, filers can work with lawyers to work through insurance disputes to seek compensation for their damages.
Do Not Make Statements without Consulting with your Lawyer First
When you are involved in an insurance dispute, do not ever make a statement to an insurance adjuster or another representative of an insurance company. This statement, even if it seems innocent, can be used to justify a lower compensation amount or to deny your claim altogether. Let your lawyer guide you through your interactions with the insurance provider.
Know the Relevant Laws and your Coverage
The insurance company could be completely in the right with its decision – if your claim does not comply with state laws or the actual coverage provided by the policy, you cannot recover compensation. But disputes can arise from misunderstandings and misapplications of the law and the details of an insurance policy, which is why you need to have an in-depth understanding of the policy and the applicable laws before you file your claim. During negotiations between your lawyer and the insurance provider, your lawyer will cite these laws and coverage points.
If negotiations with the insurance adjuster and his or her supervisor do not work, your lawyer may suggest contacting the Florida Office of Insurance Regulation to file a complaint, which could result in an investigation. If the agency finds that the insurance provider acted in error, it may override its decision.
Another option is to file a legal claim against the insurance provider to have the case heard in court or potentially resolved through arbitration or another form of alternative dispute resolution (ADR).
Draper Law Office can Help you Seek the Compensation you Deserve for your Accident Damages
If you have been injured in an accident, you have the right to work with a lawyer to file and pursue an insurance claim. To learn more, call (866) 767-4711 today to reach our team at Draper Law Office and set up your free, no-obligation legal consultation with a member of our firm.